Hand-held ophthalmoscopes have been demonstrated to be important screening tools for retinal disease. All hand-held ophthalmoscopes that are used today use the principles of either direct ophthalmoscopy or indirect ophthalmoscopy. The majority of hand-held ophthalmoscopes in present use are direct ophthalmoscopes. These devices allow an individual observer to view a patient's retina for pathology. Direct ophthalmoscopes require close proximity between the observer and the patient, have a limited field of view, and are unable to penetrate small pupils well. Indirect ophthalmoscopes allow greater distance between observer and patient, have a larger field of view, and are better able to penetrate small pupils. Both approaches permit only a sole observer at a time. In the ambulatory setting, documentation of observations must be made by sketch. Inadequate or insufficient training in ophthalmoscopy is common, resulting in a serious shortfall in the frequency of screening for retinal disease, e.g. diabetic retinopathy. We propose a digital hand-held ophthalmoscope that takes its inspiration from indirect ophthalmoscopy. It would allow for multiple simultaneous observers, immediate hard copy documentation, and improved ease-of-use. We believe that these features can increase the frequency of ophthalmoscopic screening and use, and thus, improve health care delivery. PROPOSED COMMERCIAL APPLICATION: Potential commercial applications of the hand-held digital ophthalmoscope are wide ranging. It has particular application as a screening tool for the effects of diabetes, hypertension, as well as for general retinopathy. Hard copy documentation of fundoscopy, ease of use, and multiple observer capability make it a simple and useful device for health care professionals, especially primary care physicians.